Feverfew (Tanacetum parthenium) is a flowering plant in the daisy family (Asteraceae) native to the Balkan Peninsula in southeastern Europe. Its English name derives from the Latin febrifugia, meaning “fever reducer”, though ironically the scientific evidence for fever reduction is weak. Folk medicine practitioners have used feverfew for centuries to treat headaches, menstrual irregularities, arthritis, and various inflammatory conditions.

The plant earned the nickname “medieval aspirin” due to its widespread use as a general remedy for pain and inflammation. While that historical reputation was perhaps overstated, modern research has identified parthenolide as feverfew’s main active compound. Parthenolide is a sesquiterpene lactone with genuine anti-inflammatory properties, and the clinical evidence for one particular use, migraine prevention, is actually reasonably solid.

What does the clinical evidence say about feverfew?

1. Migraine prevention (the strongest evidence)

This is where feverfew has the most compelling research backing. Migraine affects roughly one in five adults in Western countries and involves far more than just a bad headache. The attacks typically feature throbbing pain on one side of the head, nausea, and heightened sensitivity to light and sound. For people who experience frequent migraines, the condition significantly impairs quality of life.

A Cochrane systematic review examined six randomised controlled trials involving 561 participants and found that feverfew was more effective than placebo for migraine prevention, though the authors noted the evidence quality was mixed [1]. The studies used various preparations: dried leaves in capsules (typically 50-100 mg daily), CO2 extracts, and standardised parthenolide extracts.

One of the better-designed trials involved 170 people with a migraine history spanning at least 20 years [2]. Participants took a standardised feverfew extract (MIG-99, 6.25 mg three times daily) for 16 weeks. The feverfew group experienced a 39.5% reduction in migraine frequency compared to 27% in the placebo group. That difference is statistically significant, though not dramatic.

What’s interesting is that feverfew appears to work better for people who have more frequent attacks. An earlier trial using the same MIG-99 extract in people with lower migraine frequency found no benefit over placebo [3]. This suggests feverfew may be worth trying for chronic migraine sufferers but perhaps less useful for occasional headaches.

The mechanism likely involves parthenolide’s ability to inhibit NF-κB, a protein complex that acts as a master switch for inflammation [4]. Parthenolide may also affect serotonin release from platelets, which plays a role in migraine pathophysiology.

For context, feverfew’s effectiveness sits somewhere between “does nothing” and prescription migraine preventives like beta-blockers or topiramate. It’s not a miracle cure, but it may help some people, particularly those who want to try a supplement before committing to prescription medication.

2. Anti-inflammatory and pain-relieving effects

Parthenolide’s ability to inhibit NF-κB activation gives feverfew a plausible mechanism for reducing inflammation [4]. NF-κB is involved in the expression of numerous pro-inflammatory genes, so blocking its activation could theoretically dampen inflammatory responses throughout the body.

Laboratory studies and animal experiments have shown that feverfew extracts can reduce inflammation caused by various triggers [5]. Researchers extracted feverfew from flower buds and found it reduced acute inflammation in animal models of arthritis and neuralgia.

The catch? These effects have been demonstrated primarily in test tubes and animals. Human clinical trials specifically examining feverfew for general pain relief are scarce. The jump from “works in a petri dish” to “works in humans” is substantial, and many compounds that look promising in early research fail to deliver in clinical practice.

What we can say is that parthenolide does have genuine biochemical activity relevant to inflammation. Whether this translates into meaningful pain relief for people taking oral feverfew supplements remains an open question.

3. Dermatitis (topical application)

Skin inflammation, whether from eczema, contact dermatitis, or other causes, is typically treated with topical corticosteroids and oral antihistamines. These work well but carry side effects with long-term use, including skin thinning from steroids.

Researchers have investigated whether topical feverfew might offer an alternative. One study tested PD-Feverfew (a parthenolide-depleted feverfew extract, since parthenolide itself can cause skin sensitisation) and found it inhibited prostaglandin E2 production [6]. The anti-inflammatory effect was comparable to ibuprofen, and the extract didn’t cause the allergic sensitisation that raw feverfew can trigger.

This is interesting early-stage research, but I wouldn’t overstate it. A single study showing biochemical activity doesn’t mean feverfew cream will replace established dermatitis treatments. If you’re managing eczema or dermatitis, proven treatments like emollients and topical steroids (used appropriately) remain the standard approach. For more on managing skin conditions, see the NHS guidance on atopic eczema.

4. Platelet aggregation and potential cardiovascular effects

Platelets clump together to form blood clots, which is essential for wound healing but problematic when it happens inappropriately inside blood vessels. Abnormal platelet aggregation contributes to heart attacks and strokes.

Laboratory studies have found that feverfew can inhibit platelet aggregation through several mechanisms, including effects on arachidonic acid metabolism and protein kinase C signalling [7]. This suggests a potential role in reducing cardiovascular events.

However, and this is important, this evidence comes entirely from test tube experiments. No human trials have examined whether feverfew actually prevents heart attacks or strokes. The pathway from “inhibits platelets in vitro” to “prevents cardiovascular disease in humans” is long and uncertain.

I would not recommend taking feverfew hoping it will protect your heart. If you’re concerned about cardiovascular risk, proven interventions include managing blood pressure, not smoking, exercising, and taking medications prescribed by your doctor (like statins or aspirin, where appropriate). Feverfew shouldn’t substitute for any of these.

5. Rheumatoid arthritis (limited evidence)

Given feverfew’s anti-inflammatory reputation, researchers naturally wondered whether it might help rheumatoid arthritis, an autoimmune condition causing joint inflammation, pain, and eventual joint damage if untreated.

Unfortunately, the evidence here is disappointing. A six-week trial gave rheumatoid arthritis patients feverfew (70-86 mg daily) and found no improvement in clinical symptoms like morning stiffness and joint pain, nor in blood markers of inflammation such as C-reactive protein and immunoglobulins [8].

One small negative trial doesn’t definitively rule out feverfew for arthritis, but it certainly doesn’t support using it either. If you have rheumatoid arthritis, work with a rheumatologist on evidence-based treatments. Disease-modifying antirheumatic drugs (DMARDs) can prevent joint damage when started early.

Side effects of feverfew

Feverfew has been used as an herbal remedy for centuries, and serious adverse events are rare. That said, it’s not side-effect-free:

Common side effects include abdominal pain, diarrhoea, indigestion, nausea, vomiting, and nervousness. These are typically mild and more common at higher doses.

Mouth ulcers are a recognised problem when people chew raw feverfew leaves, a traditional method of consumption. Using capsules or tablets avoids this issue.

Allergic reactions can occur, particularly in people allergic to other plants in the Asteraceae family (which includes ragweed, chrysanthemums, marigolds, and daisies). If you have hay fever triggered by these plants, be cautious with feverfew.

Post-feverfew syndrome describes withdrawal symptoms that can occur if you suddenly stop taking feverfew after using it for more than a week. Symptoms may include anxiety, fatigue, headaches, muscle stiffness, and joint pain. If you’ve been taking feverfew regularly and want to stop, tapering gradually over a week or two is sensible.

Safety precautions (4 contraindications)

1. Pregnancy and breastfeeding: Feverfew should not be used during pregnancy. It may stimulate uterine contractions, and its safety during breastfeeding hasn’t been established. The NHS advises pregnant women to avoid herbal supplements unless specifically recommended by a healthcare provider.

2. Children: Safety in children hasn’t been adequately studied. Keep feverfew supplements away from children.

3. Liver or kidney dysfunction: People with impaired liver or kidney function should avoid feverfew, as the safety profile in these populations is unknown.

4. Bleeding disorders and surgery: Feverfew may inhibit platelet function, potentially increasing bleeding risk. If you’re taking anticoagulants (warfarin), antiplatelet drugs (aspirin), or supplements that affect clotting (like fish oil or ginkgo biloba), consult your doctor before adding feverfew. Stop feverfew at least two weeks before any scheduled surgery.

How feverfew is typically used

Feverfew supplements come in several forms:

Dried leaf capsules: Typically 50-100 mg daily
Standardised extracts: Often standardised to contain 0.2-0.4% parthenolide
MIG-99: A CO2 extract used in clinical trials, 6.25 mg three times daily

For migraine prevention, consistent daily use over several months appears necessary. Don’t expect immediate results. Most trials ran for 8-16 weeks before assessing outcomes.

The quality of herbal supplements varies considerably. Look for products from reputable manufacturers that provide third-party testing for purity and potency.

The bottom line

Feverfew has genuine merit for one condition: migraine prevention. The evidence isn’t overwhelming, but several randomised trials support modest effectiveness, particularly for people with frequent attacks. If you’re looking for a supplement to try before prescription preventives, feverfew is a reasonable option to discuss with your doctor.

For other uses, including general pain relief, cardiovascular protection, and arthritis, the evidence is too preliminary to recommend feverfew. Anti-inflammatory activity in a laboratory doesn’t guarantee clinical benefit.

As with any supplement, feverfew isn’t risk-free. The side effects are generally mild, but interactions with blood-thinning medications are a real concern, and certain groups (pregnant women, children, those with liver/kidney problems) should avoid it entirely.

5 Benefits and Side Effects of Butterbur - another herb studied for migraine prevention
11 Benefits and Side Effects of Aspirin - the conventional “gold standard” for pain and inflammation
3 Natural Alternatives to Anti-inflammatory Drugs - other herbal options for inflammation

References

Pittler MH, Ernst E. Feverfew for preventing migraine. Cochrane Database Syst Rev. 2004;(1):CD002286. PubMed
Diener HC, et al. Efficacy and safety of 6.25 mg t.i.d. feverfew CO2-extract (MIG-99) in migraine prevention—a randomized, double-blind, multicentre, placebo-controlled study. Cephalalgia. 2005;25(11):1031-41. PubMed
Pfaffenrath V, et al. The efficacy and safety of Tanacetum parthenium (feverfew) in migraine prophylaxis—a double-blind, multicentre, randomized placebo-controlled dose-response study. Cephalalgia. 2002;22(7):523-32. PubMed
Kwok BH, et al. The anti-inflammatory natural product parthenolide from the medicinal herb Feverfew directly binds to and inhibits IkappaB kinase. Chem Biol. 2001;8(8):759-66. PubMed
Jain NK, Kulkarni SK. Antinociceptive and anti-inflammatory effects of Tanacetum parthenium L. extract in mice and rats. J Ethnopharmacol. 1999;68(1-3):251-9. PubMed
Martin K, et al. Parthenolide-depleted Feverfew (Tanacetum parthenium) protects skin from UV irradiation and external aggression. Arch Dermatol Res. 2008;300(4):159-66. PubMed
Heptinstall S, et al. Inhibition of platelet behaviour by feverfew: a mechanism of action involving sulphydryl groups. Folia Haematol Int Mag Klin Morphol Blutforsch. 1988;115(4):447-9. PubMed
Pattrick M, et al. Feverfew in rheumatoid arthritis: a double blind, placebo controlled study. Ann Rheum Dis. 1989;48(7):547-9. PubMed